Title: Awareness of Corticosteroids for Third Molar Impaction by Dentists
Author: M.Deepigaa
DOI: http://dx.doi.org/10.18535/jmscr/v4i8.52
Abstract
Objective: The study was conducted to assess the awareness of corticosteroids for third molar impaction by dentists.
Materials and methods: A hundred dental practitioners including all specalities were included in this study, were given a questionnaire containing both open-ended and close-ended questions. The questionnaire comprised information pertaining to corticosteroids prescription for third molar surgery, commonly prescribed corticosteroids, their dosage, etc.
Results: In a total of n=100, 72% perform third molar impactions and n=28 do not perform third molar impactions .In 72% performing third molar impactions, 54% prescribe corticosteroids and 18% do not prescribe corticosteroids. In 54% prescribing corticosteroids, 33% prescribe prednisolone(oral) and 21% prescribe dexamethasone. Among 54% prescribing corticosteroids all prescribe after food .The dosage for prednisolone reported is 30 mg orally immediately after surgery, 5 mg orally twice daily for 3-5 days. The dosage for dexamethasone reported is intravenously 4mg and intramuscularly 8mg.
Conclusion: It is concluded from the present study that majority of dentists had moderate awareness of corticosteroids reducing post operative swelling and discomfort after third molar impactions They should follow and should not neglect guidelines for corticosteroids prescription along with NSAIDS
References
1. Thomas D, Walker R, Smith A, Shepherd J. The provision of oral surgery services in England and Wales 1984–1991. Br Dent J. 1994;176:215–219. doi: 10.1038/sj.bdj.4808417
2. Antila H, Lehtinen R, Heinaro A, Lansineva A, Salonen M. Successful Pain Management by Finnish Oral Surgeons. Oral Surg Oral Med Oral Pathol. 1992;74:19–23.
3. van der Westhuijzen AJ, Roelofse JA, Grotepass FW, Becker PJ. Randomized double-blind comparison of tiaprofenic acid and diclophenac sodium after third molar surgery. Oral Surg Oral Med Oral Pathol. 1994;78:557–566
4. Seymour RA, Kelly PJ, Hawkesford JE. The efficacy of ketoprofen and paracetamol (acetaminophen) in post-operative pain after third molar surgery. Br J Clin Pharmacol. 1996;41:581–585. doi: 10.1046/j.1365-2125.1996.34015.x.
5. Skjelbred P, Løkken P. Post-operative pain and inflammatory reaction reduced by injection of a corticosteroid. A controlled trial in bilateral oral surgery. Eur J Clin Pharmacol. 1982;21(5):391-6.
6. Bystedt H, Nordenram A. Effect of methylprednisolone on complications after removal of impacted mandibular third molars. Swed Dent J. 1985;9(2):65-9.
7. Beirne OR, Hollander B. The effect of methylprednisolone on pain, trismus, and swelling after removal of third molars. Oral Surg Oral Med Oral Pathol. 1986 Feb;61(2):134-8.
8. Odgen GR. Third molar surgery and postoperative pain relief. Br Dent J. 2003;194:261.
doi: 10.1038/sj.bdj.4809928.
9. Tiwana PS, Foy SP, Shugars DA, Marciani RD, Conrad SM, Phillips C, White RP. The impact of intravenous corticosteroid with third molar surgery in patients at high risk for delayed health-related quality of life and clinical recovery. J Oral Maxillofac Surg. 2005; 63:55–62.
doi: 10.1016/j.joms.2004.01.029.
10. Beeman CS. Third molar management: a case for routine removal in adolescent and young adult orthodontic patients. J Oral Maxillofac Surg. 1999 Jul;57(7):824-30.
11. Berge TI, Bøe OE. Predictor evaluation of postoperative morbidity after surgical removal of mandibular third molars. Acta Odontol Scand. 1994 Jun;52(3):162-9.
12. Conrad SM, Blakey GH, Shugars DA, Marciani RD, Phillips C, White RP Jr. Patients’ perception of recovery after third molar surgery. J Oral Maxillofac Surg. 1999 Nov;57(11):1288-94.
13. Earl P. Patients’ anxieties with third molar surgery. Br J Oral Maxillofac Surg. 1994 Oct;32(5):293-7.
14. Savin J, Ogden GR. Third molar surgery--a preliminary report on aspects affecting quality of life in the early postoperative period. Br J Oral Maxillofac Surg. 1997 Aug;35(4):246-53.
15. Hench PS, Kendall EC, Slocumb CH, Polley HF. Effects of cortisone acetate and pituitary ACTH on rheumatoid arthritis, rheumatic fever and certain other conditions. Arch Med Interna. 1950 Apr;85(4):545-666
16. Messer EJ, Keller JJ. The use of intraoral dexamethasone after extraction of mandibular third molars. Oral Surg Oral Med Oral Pathol. 1975 Nov;40(5):594-8
17. Huffman GG. Use of methylprednisolone sodium succinate to reduce postoperative edema after removal of impacted third molars. J Oral Surg. 1977 Mar;35(3):198-9
18. Olstad OA, Skjelbred P. Comparison of the analgesic effect of a corticosteroid and paracetamol in patients with pain after oral surgery. Br J Clin Pharmacol. 1986 Oct;22(4):437-42.
19. Holland CS. The influence of methylprednisolone on post-operative swelling following oral surgery. Br J Oral Maxillofac Surg. 1987 Aug;25(4):293-9.
20. Montgomery MT, Hogg JP, Roberts DL, Redding SW. The use of glucocorticosteroids to lessen the inflammatory sequelae following third molar surgery. J Oral Maxillofac Surg. 1990 Feb;48(2):179-87. 15.
21. Falconer DT, Roberts EE. Report of an audit into third molar exodontia. Br J Oral Maxillofac Surg. 1992 Jun;30(3):183-5.
22. Ito U, Reulen HJ, Tomita H, Ikeda J, Saito J, Maechara T. Formation and propagation of brain edema fluid around human brain metastases. Acta Neurochirur (Wien) 1998; 90:35–41.
doi: 10.1007/BF01541264.
23. Mense S. Sensitization of group IV muscle receptor to bradykinin by 5-hydroxytryptamin and prostaglandin E2. Brain Res. 1981;225:95–105.
doi: 10.1016/0006-8993(81)90320-6
24. Jackson DL, Moore PA, Hargreaves KM. Preoperative nonsteroidal anti-inflammatory medication for the prevention of postoperative dental pain. JADA. 1989;119:641–647
25. Babatunde Olamide Bamgbose, Jelili Adisa Akinwande. Effects of co-administered dexamethasone and diclofenac potassium on pain,swelling and trismus following third molar surgery. Head Face Med. 2005:1:11
26. Matthews RW, Sully CM, Levers BGH. The efficacy of diclofenac sodium with and without paracetamol in the control of postsurgical dental pain. Br Dent J. 1984;157:357–359.
doi: 10.1038/sj.bdj.4805486.
27. Jose Rodrigues Laureano Filho, Paul Edward Maurette, Marvis Allais. Clinical comperative sudy of the effectiveness of two dosages of Dexamethasone to control postoperative swelling, trismus and pain after the surgical extraction of mandibular impacted third molars.